Spike in sleep-related infant deaths alarms Baltimore city and county officials

A spike in sleep-related infant deaths in the Baltimore metro area is alarming medical providers and health officials, prompting them to double down on safe sleep education efforts.

Eleven babies have died in Baltimore since Dec. 1, according to preliminary data provided Wednesday by Baltimore Health Commissioner Dr. Letitia Dzirasa.


For comparison, 14 babies died in 2020 and 16 died in 2021, according to data from the city health department.

Seven of the infants who have died since December were reported to have been experiencing respiratory symptoms, Dzirasa said. A handful were infected with the respiratory syncytial virus — a sickness more commonly known as RSV that surged among young children earlier this winter.


All of the babies were noted to have been sleeping in unsafe environments, whether they were co-sleeping, not sleeping on their back, sleeping with items in their crib or sleeping around secondhand smoke, the commissioner said.

“The loss of any child is concerning,” Dzirasa said, “but we have made such progress around reducing the number of infant deaths related to unsafe sleep environments over the past couple of years. And this represents a significant setback for us.”

Baltimore County has experienced a similar increase in sleep-related infant deaths.

In a typical year, no more than five babies die in the county because of sleep-related causes, said Dr. Gregory Branch, director of the Baltimore County Department of Health. But in the first two months of 2023, there were four sleep-related infant deaths.

Unlike the city, Branch said, the county didn’t see an increase in respiratory illnesses among the babies who died. Some of the babies didn’t leave the hospital with their mothers, but instead left with another caretaker, he said.

“When a mother has a baby in the hospital, she is the one who gets educated on everything,” Branch said. “But what happens if the mother gets sick and has to remain in the hospital?”

Branch said the spike in deaths prompted the county health department to encourage health care providers to educate all caregivers on the ABCDEs of safe sleep habits:

  • A baby should sleep Alone — never with other babies, children, adults or pets;
  • A baby should sleep on their Back;
  • A baby should sleep in a Crib or bassinet — never on a sofa, chair or bed, and never with any pillows, quilts, comforters or toys;
  • Don’t smoke around the baby;
  • Always practice these steps. There are no Exceptions!

The sudden increase in sleep-related infant deaths coincided with the release of a an Abell Foundation report last month that celebrated the success of B’more for Healthy Babies, a citywide public health effort aiming to improve maternal and child health outcomes.


The campaign — launched by the Baltimore City Health Department in partnership with the Family League of Baltimore City and HealthCare Access Maryland — has achieved remarkable results, according to the report.

The city’s overall infant mortality rate dropped from 13.5 to 8.8 deaths per 1,000 live births between 2009 and 2019, outpacing the reduction in the overall state rate, which fell from 6.6 to 6.3 deaths per 1,000 live births during the same time period.

Even more laudable were gains made in the Patterson Park and Upton/Druid Heights neighborhoods, where extra funding and attention helped decrease infant mortality rates by 60% and 73%, respectively. There is no longer a racial disparity between Black and white infant deaths in either community.

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The coronavirus pandemic initially diminished the ability of organizations involved with B’more for Healthy Babies to keep up with strategies proven to prevent infant deaths — especially visiting new and expecting moms at home, Dzirasa said.

It also decreased the number of “in-person touch-times” health care providers had with families, Branch said, or opportunities where doctors or pediatricians could share public health strategies with parents like the ABCDEs of safe sleep.

But, considering the spike in infant deaths is happening now — rather than earlier in the pandemic — Dr. Robert Atlas, chair of the Department of Obstetrics and Gynecology at Mercy Medical Center, hesitates to blame it on COVID.


Since seven of the 11 babies who died in Baltimore were experiencing respiratory symptoms before their deaths, Atlas suspects respiratory illnesses played at least some role in the increase.

After hearing about the spike, Atlas said, he told his staff to “double down” on educating caregivers and parents about safe sleep practices. Doctors and nurses on his team at Mercy show new parents a video about how to put their baby to sleep safely, Atlas said. They also follow up with families after they return home from the hospital.

Anytime a baby who was delivered at Mercy dies, Atlas said, it breaks his heart.

“It’s tragic,” he said. “It’s not supposed to happen.”